北京地区HIV/HBV合并感染者与HBV单独感染者中HBV基因型分布

HBV genotype distribution in HIV/HBV co-infections and HBV mono-infections in Beijing

目的比较北京地区艾滋病病毒(HIV)/乙型肝炎病毒(HBV)合并感染者和HBV单独感染者中HBV基因型分布是否存在差异,分析两组人群中基因型相关的基本临床特征差异。方法收集2016年7月至2017年12月在北京地坛医院门诊和住院处就诊的慢性乙型肝炎患者共1 453例,分为HIV/HBV合并感染组和HBV单独感染组,通过测序来鉴定HBV基因型。结果共343例分型成功。其中,HIV/HBV合并感染者75例,HBV-B型占40.0%(30例),HBV-C型占60.0%(45例);HBV单独感染者268例,HBV-B型占27.6%(74例),HBV-C型占72.4%(194例)。在HBV单独感染者中,HBV-C型患者的丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)处于异常水平比率及乙型肝炎病毒e抗原(HBeAg)阳性率明显高于HBV-B型患者;而在HIV/HBV合并感染者中,HBV-B、C型患者的ALT、AST水平及HBeAg阳性率无显著差异。在两组人群中,HBV-B型患者在年龄、ALT、AST水平上无显著差异;HBV-C型患者在性别、年龄、ALT水平上存在显著差异。结论北京地区HIV/HBV合并感染者和HBV单独感染者中HBV基因型分布存在差异。HBV-C型患者的肝功能损害程度重于HBV-B型,HIV/HBV合并感染可能对肝功能造成一定的影响。

Objective To compare the difference of HBV genotype distribution in HIV/HBV co-infections and HBV mono-infections in Beijing and to analyze the difference of basic clinical characteristics related with HBV genotype in the two groups. Methods A total of 1 453 patients with chronic hepatitis B were collected from the outpatients and the inpatients in Beijing Ditan hospital from Jul. 2016 to Dec. 2017. The patients were divided into HIV/HBV co-infections and HBV mono-infections to distinguish HBV genotypes by sequencing. Results There were totally 343 successfully identifiable cases. In HIV/HBV co-infections, 40%(30 cases) patients were genotype B, and 60%(45 cases) patients were genotype C. In HBV mono-infections, 28%(74 cases) patients were genotype B, and 72%(194 cases) patients were genotype C. The abnormal level percent of liver function in genotype C and the positive rate of HBeAg were higher than those in genotype B in HBV mono-infections, with no difference in ALT, AST level, and the positive rate of HBeAg in genotype B and C in HIV/HBV co-infections. In the two groups, there was no difference in age, ALT and AST level in genotype B, while there were significant differences in gender, age and ALT level in genotype C. Conclusion HBV genotype distribution is different in HIV/HBV co-infections and HBV mono-infections in Beijing. The degree of liver function damage in genotype C is more serious than that in genotype B. HIV/HBV co-infection may have a certain effect on liver function.